Enhancing nonmydriatic color photographs of the retina with monochromatic views and a stereo pair to detect diabetic retinopathy.

BACKGROUND AND OBJECTIVE

Nonmydriatic digital color imaging is rapidly gaining an important role in screening for diabetic retinopathy. However, it has yet to equal a dilated fundus examination or seven Early Treatment Diabetic Retinopathy Study field 35-mm photography. The authors therefore attempted to enhance efficacy and validity by adding two low-cost steps to the nonmydriatic digital image evaluation.

PATIENTS AND METHODS

The fundi of 145 consecutive patients with diabetes mellitus were evaluated for diabetic retinopathy using two different nonmydriatic reading techniques: creating a red-free view (using digital filters) and looking at a stereo pair of each field taken. These methods were each compared to a mydriatic fundus examination.

RESULTS

Although the first technique yielded views with sensitivities and specificities similar to what exists in the literature using this same technique, enhancing these photographs (second technique) yielded a statistically significant increase in sensitivity and specificity (P < .005).

CONCLUSION

The authors recommend using both low-cost steps when screening for diabetic retinopathy through nonmydriatic digital color imaging.